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All content was reviewed and approved by the EBMT Committee, which held full responsibility for the abstract selections. Log rank test, Gray test and Cox regression models were used for statistical analysis. Median follow-up was RUNX1 mutation neither had any impact among patients with normal karyotype. Furthermore, no other outcome parameter was influenced by RUNX1 mutational status.

Hence, transplantation in CR1 might overcome the unfavorable prognostic value of RUNX1 mutation and can be recommended as consolidation treatment in this entity. Its incidence depends on multiple parameters including type of donor, HLA disparity, stem cell source, graft composition and conditioning regimen. Secondary AML was reported in Stem cell source was bone marrow BM in Cumulative incidence of GF was 6.

Disease recurrence was the most common cause of death, with infections and GVHD being the most frequent transplant related causes. RIC and adverse cytogenetic risk were associated with relapse and age, performance status and cytogenetic risk with OS. Background: Several prognostic models to stratify allogeneic hematopoietic cell transplantation allo-HCT outcomes have been developed in recent years. Our proposal is to validate both scoring systems in a cohort of patients who underwent ex vivo CD34 selected HCT.

The primary outcome was survival OS and secondary outcomes were progression-free-survival PFS , and incidences of non-relapsing mortality NRM , and relapse. Results: Median age was 55 years range 19 to 73 years , All patients received myeloablative conditioning. At time of HCT Median follow-up was 5. The OS predictive accuracy measured by c-statistic was 0. The predictive accuracy for both scoring systems is modest, however; and there remains a need for innovative models incorporating new clinical and genomic characteristics to achieve a scoring system with improved accuracy.

Actinium Pharmaceuticals Inc. Inc, Magenta Therapeutics. Background: Relapse following allo-HSCT in patients with acute leukaemia remains to date a challenge in clinical practice and is associated with ominous prognosis. Identifying the mechanism leading to relapse will morph our therapeutic armamentarium in accordance with the underlying pathophysiology. Analysis was performed using the FlowJo software Version Statistical analysis was performed using Graph Prism. At the time of transplantation, 5 patients achieved CR1, 7 achieved CR2 and 4 had refractory disease.

The median day of relapse was day We first describe this mechanism to be present in cases of ALL. Identifying this phenomenon in patients using flow cytometry provides valuable information concerning their treatment choices as they will obviously not benefit from donor lymphocyte infusions.

Background: Stem cell transplantation SCT plays a central role in the management of haematological malignancies and is increasingly utilised in the management of non-malignant disorders. Treatment toxicity and disease relapse remain major causes of treatment failure after both autologous and allogeneic SCT.

In contrast to other areas of haemato-oncology where clinical practice is informed by large prospective randomised trials, transplant practice is largely informed by retrospective registry studies and local practice. Very few patients undergoing stem cell transplantation enter prospective randomised trials aimed at improving transplant outcome. Reasoning that major barriers to transplant trial delivery was the twin absence of resource for trial development and research nurse capacity within a large networked population, a 4-year pilot was established in to create a national transplant trials network in the UK.

Funding was awarded with the aim of recruiting at least patients to 9 prospective trials with embedded sequential collection of clinical samples. The IMPACT grant funded a central Hub within a well-established Clinical Trials Unit which was responsible for clinical trial design, set-up, management, and publication of trial results.

The Hub was linked with a Trials Network consisting of 10 major transplant centres each staffed by a dedicated IMPACT research nurse chosen through an independent peer review process. This effectively created a funded trials network able to recruit to transplant trials in a cohesive manner across a 20 million patient population. Results: In the 24 months since its establishment the IMPACT network has received 28 proposals for transplant trials - 12 of which have been developed with expert statistical and clinical input from the IMPACT team through national workshops.

Rapid feasibility assessments were performed for 10 of these trials. To date 7 trials have been submitted for independent peer review and six have been approved. Key transplant questions addressed include defining the optimal conditioning regimen in acute myeloid leukaemia and acute lymphoblastic leukaemia, studying the role of post-transplant maintenance and donor lymphocyte infusion DLI and optimising graft-versus-host disease prophylaxis.

Of note, one trial - Pro-DLI, a randomised trial of DLI administration post-transplant-has fully recruited within 24 months - 8 months ahead of its scheduled target. Key to this success has been its ability to accelerate and coordinate both trials set up and recruitment across a 20 million population. Further investment in such accelerated trial models is required across Europe if patient outcomes after stem cell transplantation are to be improved.

Methods: Clinical data for patients who were diagnosed as having ALL between and were collected from 21 centers in Hokkaido, Japan. Results: The median age of the patients was 55 years range: years. Ninety-two of the patients were pediatric years , 86 were AYA years , were adult years and were elderly patients years.

Cytogenetic G-banding results were available in patients. Three hundred forty-seven patients had abnormal karyotypes AK , and patients had normal karyotype NK. Abnormalities of complex karyotype were seen in 94 of the patients. After a first remission induction therapy, of Background: The curative effect of HCT for acute leukaemia is due in part to the donor T cell-mediated graft-versus-leukaemia reaction GvL.

Yet, post-HCT relapse remains a major cause of treatment failure. By Cox multivariate proportional hazard regression, the effect of donor blood Foxp3 mRNA level on relapse did not meet the proportionality assumption. Proportionality was achieved after dichotomy at the median time of relapse. However, after day a higher donor Foxp3 mRNA level was associated with an increased risk of relapse. Thus, seven of eight late relapses occurred in recipients from donors with pre-harvest Foxp3 mRNA level above the median.

In the multivariate regression analysis, a significant interaction between the pre-harvest donor CD4 T cell concentration and the use of ATG in the conditioning regimen was observed, indicating that the effect associated with donor CD4 T cells was modified by ATG, compatible with the notion that the effect associated with donor CD4 T cell concentration was abrogated in recipients who received conditioning including ATG.

However, due to the small sample size it is premature to draw definite conclusions regarding the effect of ATG. Cumulative relapse incidence curves supported the Cox univariate and multivariate regression analysis. Furthermore, we observed a reduction of the probability of surviving in continuous CR associated with higher pre-harvest donor Foxp3 mRNA level and decreased pre-harvest donor CD4 T cell concentration.

Background: To review epidemiology, management, use of resources, and costs of acute myeloid leukaemia AML and myelodysplastic syndrome MDS via the evaluation of patient records. The database contains patient records compiled in private and public hospitals, covering all Spanish regions, between and for AML and between and for MDS, according to data availability.

The costs of healthcare usage were calculated based on the mean costs of medical procedures as determined by the Spanish Ministry of Health, which exclude prescription medication. Patients were mostly between 70 and 89 years of age and predominantly male. There was an increase in bone marrow and hematopoietic stem cell transplants over time in Spain during the study period, from in 1, patients to in 3, patients. Conclusions: This retrospective study identifies patient characteristics, disease management, and health resource use related to AML and MDS treatment in Spain.

A large portion of these costs can be attributed to the increasing number of bone marrow and hematopoietic stem cell transplants. The other authors have no conflicts of interest to declare. In individual patients, bone marrow cellularity BMC at pre-transplant assessment PTP and post-treatment pancytopenia leading to classification as CR-incomplete [CRi] as per ELN criteria may be a manifestation of disease persistence, and this clinical response to chemotherapy is concerning for treating physicians.

Data was updated as of November Median age was 57 years range Donors were matched-unrelated, matched-related and haplo-identical related , and The median follow-up of survivors was 31 months Results: OS of the whole cohort at 2y was OS for BMC was aplastic Hypocellularity and CRi should not be considered negative prognostic factors for post-transplant outcomes of AML. OS was calculated by Kaplan-Meier analysis. Results: Relapse occurred at a median of 7. With a median follow-up of In multivariate analysis, female gender HR 0.

Sebastian Giebel: Amgen: honoraria, advisory boards, travel grants; Pfizer: honoraria, advisory baords. Background: In , Sorror et al introduced a new prognostic scale for the candidates of allogeneic. Since then, several methods were developed to predict the risk of transplant related mortality. Medical records of the patients were retrospectively reviewed. Disease risk stratification was based on European Leukemia Net guidelines. Pre-transplant disease status was first complete remission CR1 in patients A total of HSCTs Graft source was peripheral blood in Conditioning regimen was myeloablative in Group 1 represented low-risk patients, whereas Group 2 was composed of intermediate, high and very-high-risk patients.

Sinusoidal obstruction syndrome was found to be more frequent in Group 2 Both patient and disease related factors may have a role in predicting transplant related morbidity and mortality. This retrospective study underlines the importance of pre-transplant risk evaluation, although more experience is required to identify the better approach in order to improve our foresight in allo-HSCT setting.

Here we analyze the efficacy and application of VEN in this setting. Time from transplant to relapse was days range Median of VEN cycles was 2 Full molecular information was available for 10 pts at diagnosis and in relapse post-alloHCT: 3 pts acquired TP53 mutations at relapse. Figure 1 outlines evolution of molecular abnormalities in the rest of the cohort, associated venetoclax doses and best responses.

None of the pts experienced graft failure after salvage therapy. Estimated median overall survival after VEN was 73 days Range 2- The most common molecular mutation among responders was TP Among 5 pts with TP53 mutation in our cohort; 3 achieved CR. Our observations provides evidence that even in the context of post-transplant relapse with adverse mutations and limited treatment options, VEN- based therapy may be effective in inducing CR and possibly improves survival in responding patients.

Mrinal Patnaik: Stem Line Pharmaceuticals. Background: In modern practice, a significant proportion of adult patients with acute lymphoblastic leukemia ALL undergo allogeneic bone marrow transplantation allo- HSCT. Gorbacheva Memorial Institute between and Median follow-up time was 30 months range, months.

Disease status was the main factor determining the results of transplantation in Ph-negative ALL patients. Achievement of MRD-negative status is crucial for the outcome thus the studies of bridging strategies are warranted. Two different techniques are currently available for posttransplantation surveillance of disease remission: characterization of posttransplantation chimerism and specific detection of MRD.

In this retrospective single-center study, we have attempted to evaluate the impact of both chimerism and flow-cytometric MRD in relapse in a population of patients with AML who received an allo-HSCT. Chimerism and MRD analysis were performed routinely at 1, 3, 6, 9, 12 months after transplantation at our hematology laboratories.

We used our institutional database to evaluate details and characteristics of patients and transplant outcomes. Median follow up from allo-HSCT was A total of 36 The stem cell source was peripheral blood stem cells in 63 patients Fifty-patients received myeloablative conditioning, whereas 15 received a reduced intensity regimen.

In addition, at time of relapse among study population only 33 patients had mixed CD3 chimerism. The median time to hematologic relapse after detection of MRD relapse was median 62 days. Among all patients, 23 patients with MRD relapse and subsequent hematologic relapse also have been detected via a decrease in chimerism.

During follow up 41 deaths were noted. Conclusions: In light of recent advances in therapeutic options for post-transplantation relapse, improving our understanding of the available relapse prediction tools is becoming increasingly important.

Our data presented here show the superiority of flow cytometric MRD over chimerism analysis to predict relapse after allogeneic stem cell transplantation. Therefore, further studies of larger randomized cohorts with high quality data management are required to clarify the role of post-transplantion MRD and chimerism in predicting relapsed in AML.

Sorafenib was given off-label after provision of an informed signed consent and in the absence of alternative therapeutic options in all patients. Indications were both achievement of complete morphological remission CR and hematological engraftment. Exclusion criteria were active GvHD, infections and non-hematological toxicities. Sorafenib administration was prolonged until intolerance or disease progression. Results: clinical-biological features at baseline and at sorafenib initiation are reported in Figure 1.

Median time from HSCT to sorafenib initiation was days range Nine out of 10 patients were still on GvHD prophylaxis. Sorafenib starting dosage ranged from mg QD 6 patients to mg BID 4 patients depending on clinical conditions and concomitant medications.

Sorafenib was well tolerated: no hematological toxicity was observed. Any patient died because of treatment. Four patients had dose reduction and 2 patients had temporary interruption of sorafenib because of AE. Two patients developed acute GvHD grade 2 overall: no one had previous GvHD; one patient obtained complete remission with steroid treatment, the second completely resolved GvHD after second line therapy infliximab. After a median follow up of 15 months range , all patients were alive.

Nine patients were still on therapy while 1 patient finally stopped sorafenib after 4 days of administration due to a drug-related grade II sinus bradycardia. Median duration of maintenance was days range Sorafenib was effective both in preventing relapses and obtaining deep and durable remission.

Secondary end points:to describe causes, incidences rates PC and risk factors of such complications following allo-HSCT. Clinical data were analyzed to determine whether the incidence of PC was correlated with risk factors such as age, sex, underlying disease type, transplant type, conditioning regimen, prophylaxis of GVHD using SPSS Kaplan-Meier curves were used to estimate the probability of OS.

According to our data pulmonary changes were seen in 80 pts. Three pts developed hydrothorax. Intensity of conditioning regimen does not affect the incidence of PC in patients with CR. Background: Although the need for consolidation chemotherapy after successful remission induction therapy is well established in patients acute myeloid leukemia AML in first complete remission CR1 , the value of consolidation chemotherapy before HSCT remains controversial.

All of these patients received MSDT in different centers. In the present study we added information from microarray CNV analysis. Results: 1. Numbers of CNVs deletions in the patients varied from median: 22 , amplifications from median: Only autosomes were analysed. A majority of discrepant results between the FISH or CBA and microarray were likely due to difficulties in proper identification of a part of additional or deleted chromosome seen 6 patients.

Altogether, the results of CNV and the standard techniques were the same in 25 cases. In a univariate analysis of the survival risk factors, it was found that better overall survival enjoyed patients:. Background: Allogeneic hematopoietic cell transplantation HCT may provide cure for acute leukemia where indicated.

However, its use is limited by transplant-related complications which lead to increased mortality. Data was updated as of October Results: Median age was 56 years range The median follow up of survivors was 37 months months. Multivariable analysis for OS demonstrated that leukemia type HR 1. New approaches are required to develop a pre-transplant risk calculation tool that can be widely applicable to patients from various centers characterized by heterogeneous practices.

Introduction of targeted drugs is the most promising strategy in the modern therapy of hematological malignancies. Results: The follow-up period was 27 month. In two cases alloHSCT was done in active disease. In all cases we observed neutropenia of 4 gr. Sinusoidal obstruction syndrome did not occur in any of the patients. Causes of death were leukemia progression 1 pt , infectious complications 3 pts.

No direct association with the GO and death was observed. The benefit of allogeneic stem cell transplantation AlloHCT in this setting is controversial. This study aims to assess outcomes in this group of patients undergoing AlloHCT. Results: The median age of patients was 50 years old range Patient and transplant characteristics are summarized in Table 1. With a median follow up of 4 years, 2-year relapse free survival RFS was Compared to other chromosome 3 abnormalities, patients with monosomy 3 showed the highest risk of relapse and death with 2 year RFS On univariate analysis, age greater than 50, monosomy 3, the presence of monosomy 7 and Allo-HCT in AML in CR2 or not in remission, were associated with increased risk of relapse and death.

The presence of monosomy 7 also showed a trend towards increased risk of relapse, however, this was also not statistically significant HR 2. Further studies with a larger sample size and the inclusion of molecular mutations are recommended. Cytogenetic aberrations and response to the treatment are important prognostic factors in AML. MLL gene rearrangements in AML patients result in unique clinical and molecular genetic characteristics and generally indicate a poorer prognosis.

Results: A total of 21 out of The commonest identified partner was t 9,11 in 8 patients Three patients died early within 1 month from diagnosis. Three out of 18 One patient failed to achieve CR despite second-line chemotherapy. All relapsed patients failed to achieve CR2 and died with PD. MLL-rearranged AML patients associated with increased risk of early relapse and re-induction failure. CR1 after first-line chemotherapy is an independent prognostic factor. Background: Results of allogeneic stem cell transplantation SCT in primary or secondary refractory leukemia patients remain unfavorable despite the studies of new conditioning regimens.

Preclinical studies by Stokes et al. All patients received myeloablative conditioning with fludarabine and busulfan. Four pts had matched sibling donor, 15 - matched unrelated donor and 7 - haploidentical, 10 pts had primary refractory and 16 secondary refractory disease. Half of patients received systemic antimicrobial therapy at the time of enrollment. Median age was 27 years According to ELN classification they are characterized as favorable or intermediate risk depending on the coexistence of FLT3 mutations.

For pts with a favorable risk profile an allogeneic hematopoietic stem cell transplantation HSCT in first complete remission CR is not recommended, but can be an option for the intermediate risk group, depending on risk factors like comorbidity. With this strategy relapse can be detected earlier with lower leukemia burden.

HSCT in molecular relapse could avoid possible complications of reinduction chemotherapy, but there are no data for this strategy. In we decided to start donor search immediately after molecular relapse and proceed to HSCT without reinduction chemotherapy.

Here we report our experience with the first 6 pts treated with this strategy. In 10 pts HSCT as consolidation treatment was performed. MRD was monitored at least every 3 months mos after end of consolidation therapy by qPCR in bone marrow or peripheral blood in all pts in hematological CR.

In 6 pts molecular relapse was detected. The median time to molecular relapse was 8 mos after diagnosis. All pts reached complete hematological and molecular remission after HSCT. After a median follow-up of 15 mos all pts are in ongoing CR. In all but one pt the remission free survival is longer than after primary treatment. Conclusions: Although the number of pts is small and the follow-up short, this analysis shows the efficacy and feasibility of early allogeneic HSCT in molecular relapse for NPM positive AML pts and should be confirmed in a greater number of pts.

Background: consolidation of complete remission CR with autologous stem cell transplantation ASCT is an option for patients pts with acute myeloid leukemia AML , in particular for those with a favourable genetic risk ELN Most conditioning regimens for ASCT contain at least one alkylating agent, usually busulfan, cyclophosphamide or melphalan. Up to now, no regimen has proved preferable in terms of toxicities and improvement of event free survival EFS.

Treosulfan is an alkylating agent which demonstrated to achieve maximum disease control with minimal toxicity in combination with fludarabine prior to allogeneic SCT. Preliminary data on the feasibility and efficacy of the FLAT regimen are here presented. Cytogenetics: favourable 1, intermediate 26 normal karytotype 25 , complex 1, not evaluable 2. Prognostic risk ELN : favourable 14, intermediate 7, adverse 1, not evaluable 8.

There was no difference in the 3-year cumulative incidence of relapse. In contrast, an EBMT study of patients showed that post-transplant TKI was associated with a lower relapse rate and better overall survival. Recently, Akahoshi et al reported that TKI prophylaxis was not associated with a decreased risk of relapse or superior overall survival in the whole cohort.

Methods: The Institutional Research Board approved the retrospective study. Univariate and multivariate analysis was performed using Cox proportional hazard regression model. The median duration of TKI treatment of the patients was days range, days. This result could be explained by the fact that 21 of the 32 patients with molecular relapse received TKI treatment and 9 of them returned to negative MRD in a later follow-up assessment.

Conclusions: Despite the limitation of small sample size and the potential bias of patient selection by the physician, our study showed TKI treatment after allogeneic HSCT would reduce relapse and improve overall survival, indicating the potential benefit of TKI treatment in the post-transplant setting.

Background: Acute myeloid leukemia AML has been recognized as a clinically and genetically heterogeneous disease entity. Cytogenetic abnormalities that are associated with the prognosis of AML have been identified. However, as there are limitations for patients in the cytogenetic intermediate-risk group, more precise risk stratification systems based on genetic status have been proposed especially in nest-generation sequencing NGS era.

In this study, we evaluated the usefulness of the European Leukemia Network ELN risk stratification system and transplant outcomes in the cytogenetic intermediate-risk group. Results: According to the ELN risk stratification system, 30 The 5-year overall survival OS rate was The outcome of allogeneic hematopoietic stem cell transplantation HSCT was evaluated in patients who achieved complete remission.

Among them, 71 Despite the higher proportion of patients receiving more than 2 cycle of induction chemotherapy Conclusions: The molecular risk stratification of the ELN successfully distinguished long term prognosis in cytogenetic intermediate-risk AML patients and validated in our center.

Because molecular evaluation using NGS technique recently became one of standard pre-treatment evaluation for AML patients in Korea, clinical benefit of HSCT should be carefully and precisely evaluated for cytogenetic intermediate-risk patients according to the molecular risk stratification. Furthermore, more effective post-remission treatment strategy should be determined especially for cytogenetic intermediate- and molecular poor-risk AML patients. Methods: The expression of WT1 gene was measured by real-time polymerase chain reaction in peripheral blood according the European Leukemia Net recommendations.

Median age was 46 years range; , 76 men, 21 good risk, intermediate risk 91, high risk A total of pts were transplanted in CR1 and 31 pts in CR2. In pts PBPC were used, in 19 pts bone marrow. The donors were identical siblings in 30 pts, 9 haploidentical, matched unrelated donors in 73 pts and mismatched UDs in 35 pts. Conditioning was myeloablative in pts, RIC in 30 pts. Results: Median follow-up was 21 months. Overall 50 pts developed WT1-MRD positivity in post-transplant period, in forty cases the therapeutical intervention was done.

Haematological relapse occurred in 42 pts, in all relapsed patients where WT1-MRD was monitored 38 pts we detected the positivity, in median of 28 days before haematological relapse. Conclusions: The results of the analysis confirmed our previous experience that WT1 status before allo-SCT is a strong prognostic factor for both OS and relapse risk.

Well-defined clinical studies will be needed to assess the importance of therapeutic intervention based on WT1-MRD positivity. Background: Widespread use of targeted therapy with tyrosine kinase inhibitors TKIs in combination with allogeneic hematopoietic stem cell transplantation allo-HSCT has dramatically improved therapy results in the majority of Ph-positive acute lymphoblastic leukemia ALL patients, so nowadays their survival may be comparable with Ph-negative ALL patients in most cases.

Nevertheless, relapses remain a major cause of treatment failure even after allo-HSCT that lead to dismal prognosis. One of the possible strategies to prevent relapse includes posttransplant TKIs maintenance, but the data about its application regimens is still controversial. Median follow-up time was 24,8 months range, months. Landmark analysis was used for comparison with patients without TKIs.

Non-engrafted patients were excluded from analysis. Thus, we can suggest that in order to reduce risk of relapse, it is preferable to prescribe TKIs no later than 60 days after allo-HSCT, before measurable residual disease appear, if there are no other factors that limit TKIs administration toxicity of TKIs, poor graft function, etc.

However, ATG can potentially eliminate alloreactive donor T cells and reduce the graft-versus-leukemia GVL effect and increased disease relapse and reduced overall survival OS. Methods: This was a retrospective single center analysis using the data set of our institutional database. All recipients received peripheral blood stem cells grafts. All analyses were done separately in patients achieving or not MRD negativity before transplant.

Median age was 48 years range and 40 Median follow up from allo-HSCT was 9. Fifty-five Infection was the most common cause of death in the both groups. However, further prospective, randomized studies on a large number of patients are warranted to clarify these findings. Methods: The clinical characteristics and prognosis of 32patients with MLL-AF6 fusion gene positive acute leukemia from May to September were retrospectively analyzed.

Twenty four patients received allogeneic hematopoietic stem cell transplantation, including 21patients with AML and 3 patients with T-ALL. Median age was 22 years old. The median time from diagnosis to HSCT was 24 months. One patient failed to engraftment and one patient was not engraftment. DLI infusion was used to prevent recurrence in most patients after transplantation. Eight patients received chemotherapy, all of them were AML patients, 5 males and 3 females, the median age was The OS rate was Conclusions: This study shows that MLL-AF6 acute leukemia has poor response to conventional chemotherapy and poorprognosis, so it is necessary to carry out allogeneic hematopoietic stem cell transplantation in remission state as early as possible.

Background: Blastic plasmacytoid dendritic cell neoplasm BPDCN is a rare aggressive hematologic neoplasm which originates from the professional type I interferon-producing cells or plasmacytoid monocytes. Although several retrospective and small case series has been published so far, there is few population-based study on BPDCN classified after WHO classification in Asian populati. Pathologic slides were reviewed in the central lab by the 2 pathologic experts and were finally confirmed for diagnosis.

Overall survival was defined by the period from the date of the initial diagnosis to death by any cause or follow-up loss. Results: The median age of the patients was The most common initial presenting site was skin followed by lymph nodes, bone marrow, spleen, and liver. Among the 32 patients who received induction chemotherapy, 11 cases proceeded to allogenic stem cell transplantation SCT and 3 received autologous SCT.

Conclusions: Induction treatment with leukemia-like regimen and proceeding to allogeneic stem cell transplantation can prolong overall survival in Asian patients with BPDCN. Background: Anti-apoptotic proteins like Bcl-2, Bcl-Xl, or Mcl-1 play an important role in tumor cell survival and has been considered attractive drug targets. Especially, Bcl-2 selective inhibitor, venetoclax, has been showing significant effects on hematologic malignancies, but lower sensitivity and resistance gain have to be overcome to achieve durable response in acute myeloid leukemia AML.

Apoptotic cells were measured after 24 hr treated with each agent or combination. Apoptosis was analyzed using Annexin-V assay. For these cell lines, cotreatment of HMA to venetoclax synergistically potentiated apoptosis, and relatively lower concentrations of both drugs could induce almost complete apoptosis.

For venetoclax resistant THP-1 and U cells, venetoclax could not induce sufficient apoptosis even with higher concentration. Conclusions: Our study suggests that co-targeting of Bcl-2 and NHE1 pathways not only sensitized the AML cells to venetoclax but also suggests that it could be one way to overcome venetoclax resistance in AML. Background: Outcome of allogeneic hematopoietic stem cell transplantation alloHSCT for acute leukemia AL is superior when performed in complete remission.

Therefore, in refractory or relapsed patients not in remission after induction, consolidation or re-induction treatment, salvage strategies are being employed to reach at least marrow aplasia without residual blast morphology. GO could be obtained for bridging to transplant in 32 patients, whereas patients had to be transplanted without bridging. Both cohorts of CD33 positive patients were comparable for age, gender, disease subgroups, donor source, HLA matching, and conditioning intensity.

Results: clinical-biological features at baseline and at relapse are reported in Figure 1. Median time from HSCT to relapse was 10 months range Median number of AZA cycles was 4 range No patient died because of treatment. Background: Although allogeneic transplantation brings a substantial survival benefit in AML, post-transplant relapse remains one of the major events leading to treatment failure.

Together with non-existing definite approach guidelines it causes difficulties in further treatment decision. Patients who relapsed earlier from transplant did worse in the first two years, but the difference disappeared in surviving patients after 24 months of relapse treatment. Another major contributor to death was GVHD.

Conclusions: The outcome of AML patients relapsing after allogeneic transplantation is very poor despite various treatment approaches. The survival benefit was seen in patients who achieved further remission, though the subsequent relapses were frequent. Treatment toxicity was rather high in this group of patients. The emphasis on prophylactic and preemptive treatment together with tight minimal residual disease monitoring should be carried out, and the introduction novel drugs e.

The median age at transplantation was 56 years range, years. Twenty four per cent of patients had a refractory disease at first assessment after HSCT. No specific subgroup of patients was identified in terms of better outcome. However, the high incidence of early post-transplantation relapse reveals the persistent need to improve the procedure.

The key points reported in larger trials are early donor identification, easier with the availability of haplo-donors, use of sequential conditioning regimen, early tapering of immunosuppression and post-transplantation maintenance, such as targeted therapies, hypomethylating agents, donor lymphocytes infusions or other forms of immunotherapies.

Methods: The study included pts for the period , median m age was 36 years. The m follow-up was 24 months. In int the year of alloHSCT was evaluated vs Given the improvement of transplantation methods for patients of the intermediate group, alloHSCT is recommended in CR1. The outcome of alloHSCT from matched unrelated donor comparable with matched sibling donor.

Background: Post remission therapy in patients with acute myeloid leukemia AML consist of giving maintenance chemotherapy or allogeneic hematopoietic stem cell transplantation AlloHSCT in high risk patients as a curative therapeutic option. Conflicting results have been reported on the impact of ABO mismatch on various transplant outcomes such as neutrophil and platelet engraftment, acute and chronic graft versus host disease GvHD , non-relapse mortality and overall survival.

In this study, we evaluated the demographic and clinical characteristics of patients, the effect of ABO mismatch and graft source on HSCT outcomes, such as engraftment and graft versus host disease GvHD. The median age was 31 years range 3- 60 years. PBSC was the major source of graft, and matched sibling were the predominant donor type There were 26 patients with gender mismatch Among the recipients, ABO group mismatch was seen in 15 patients Majority of patients received Bu-Cy as conditioning regimen The mean time to neutrophil engraftment was Patients with fully matched sibling donor had statistical significant association with improved survival outcome p 0.

On comparing different variables in terms of standard deviation using unpaired t test, age at transplant was the only variable with significant association with survival outcome p. Conclusions: Our experience with ABO mismatch is encouraging with good tolerability and disease control even in the advanced stage heavily pre-treated patients. More aggressive strategies including second transplants and novel agents are needed in these patients on relapse. Background: Outcomes in elderly AML remain poor due to high risk of relapse, higher incidence of adverse cytogenetics and of chemotherapy resistance.

The advent of reduced intensity conditioning RIC regimens has led to increasing use of allogeneic transplant in patients over the age of This can lead to durable disease free survival in this age group and improved outcomes compared to that achieved with chemotherapy alone. Data was collected from Electronic patient records. Results: patients were included in the study with a median age of 65 years range - Patients with MMUD had inferior OS and PFS compared to those with a sibling or MUD donor in this age group and the decision to perform a mismatched unrelated donor transplant in this age group should be carefully assessed.

Whilst numbers of UCB were small, the of use of alternative donors rather than MMUD in this age group should be considered and warrants further evaluation in randomised setting. Background: Myeloid sarcoma MS as a solid extra-medullary manifestation of acute myeloid leukemia AML is a rare presentation of relapse after allogeneic hematopoietic stem cell transplantation HSCT.

It may occur as an isolated extra-medullary relapse, multilocular or in association with a medullary relapse. Of those, 12 patients 3. Results: We identified 12 patients median age 53 years with MS. They all received reduced intensity conditioning RIC. The median onset of MS was The regions and organs affected varied from very typical tissues such as skin, bone or lymph node up to extremely rare presentations of MS affecting the pituitary gland, breast tissue, the thoracic wall or the paranasal sinuses.

Eight Concerning the treatment, various therapy options were considered. The most frequently applied treatment options were intrathecal triple therapy, cytarabine and azacytidine. None of the patients received another HSCT. Irradiation was implemented where possible. The median overall survival since diagnosis of MS was Conclusions: These observations demonstrate the limitations of graft-versus-tumor effects after HSCT, since extra-medullary relapse did occur in the presence of GvHD.

The results may also indicate that reduced intensity conditioning protocols are associated with a higher rate of extra-medullary relapse. Single isolated manifestations are more frequently treated successfully compared to multilocular manifestations of MS. This is in part due to fewer issues regarding accessibility by local therapies such as irradiation or intrathecal therapy in cases of involvement of the central nervous system.

Background: Allogeneic stem cell transplant remains the best consolidation therapy in intermediate and high-risk AML patients with a suitable donor. We conducted a retrospective analysis to identify those who may benefit from further intensification of therapy. Methods: Eighty patients, aged All living patients have been observed for at least two years.

The FLT3 inhibitors were not used in this cohort. Conclusions: In patients with low- and intermediate risk AML and PIF the allogeneic stem cell transplant may overcome the resistance to induction therapy. The efficacy of allogeneic stem cell transplant is limited in this cohort and the overall survival is poor. These patients may most benefit from innovative treatment approaches. Background: Patients with acute myeloid leukemia AML who did not achieve remission after first induction chemotherapy have a dismal prognosis.

Prior reports have shown that these patients could be rescued with allogeneic hematopoietic cell transplantation HCT. As second induction chemotherapy, most patients received high dose cytarabine-based regimen. The median number of chemotherapy lines before transplantation was 2 range, The median time from diagnosis to first CR was days range, Table 1 shows some characteristics of patient population at time of first transplant.

Of them, 5 died for leukemia, 6 underwent a second transplant after achieving second CR, 1 is waiting for second HCT and 1 is leukemia-free after sorafenib therapy. Among 6 patients who received a second transplant, 2 are living and cured, 2 died for infections, 1 died for VOD and 1 died for leukemia relapse.

Nine patients died for transplant-related causes at a median of 53 days range, after transplant. Causes of death were infection in 5, acute GvHD in 2, and heart failure in 2. As of November , 16 patients are living and doing well after a median follow-up of months range, Conclusions: This study demonstrates that allogeneic HCT may produce durable remission and cure in patients with AML who failed first induction chemotherapy.

Background: It is generally recognized that allogeneic hematopoietic stem cell transplantation allo-HSCT should not be managed to patients with active infection. However, in patients with severe aplastic anemia SAA especially very severe aplastic anemia VSAA , it is usually difficult to control the infection without neutrophil. Rapid recovery of neutrophil by allo-HSCT might be a salvage treatment to control infection and rescue the patients.

To evaluate the efficacy of allo-HSCT for SAA patients with refractory active infection, we designed this multicenter prospective clinical study in China. Methods: Refractory active infection was defined as persistent fever without response to broad-spectrum antibacterial and antifungal treatment for more than three weeks with or without a definite infected site, or there was a definite infected site with fever less than 3 weeks.

The probabilities of overall survival OS were calculated using the Kaplan-Meier estimator and compared between two groups using the log-rank test. The cumulative incidences were calculated using competing-risk models and analyzed by the Grey test between groups.

Results: Totally 75 patients were enrolled in this study from April to July All patients had persistent fever, including 52 For the prompt engraftment, peripheral blood stem cells PBSCs were given to all of our patients. Meanwhile, bone marrow was co-transplanted with PBSCs in 40 The median age was 6. Seven 9. Two 2. The other patients sustained complete donor chimerism after HSCT. The median time for myeloid engraftment was 13 days range, 9 to With a median follow-up of days range, 2 to , the probability of OS was Haploidentical family donor is a good donor if without matched sibling donor.

Peripheral blood stem cell may be the better graft source for this salvage HSCT owing to the rapidly engraftment. Background: Aplastic anemia AA is a rare, and life-threatening hematological disease. It is known that its incidence and prevalence might vary substantially among different geographic regions, and its presentation has been sometimes linked to environmental exposures.

In the north of Spain, our group found 2. In Sweden, an incidence of 2. Our aim was to know the incidence and epidemiology of AA in a well-defined population. Methods: In an ambispective study IMAS , 7 general hospitals from 7 provinces situated in different geographical regions, that take care of a population of around 3. All the patients diagnosed with AA were included.

Data bases of the Hematology, Pathology, and Pharmacy Departments were used as a source of information. The incidence of AA was 2. The median age at diagnosis was 56 years old , and gender was distributed almost equally between females and males. More than half of the cases were severe or very severe, and 9 out of 10 of the patients had transfusion needs. HSCT was a very infrequent 1st line therapy. At 1 year, two-thirds of the patients were in response partial or complete.

With a median follow-up of 6 years, threequarters of the patients were alive. See table. Conclusions: 1 Worldwide, there are few studies focus on the epidemiology and management of AA patients. Particularly, this is the first national study of these characteristics ever performed in Spain; 2 We found an incidence of AA of 2.

Background: Allogeneic hematopoietic stem cell transplantation HSCT is a curative treatment for children with severe aplastic anemia AA. With the improvement in HLA typing resolution and advancement of supportive care for graft-versus-host disease GVHD , various donor options are available for patients without HLA-matched sibling donors, such as unrelated donors, HLA-mismatched family haploidentical donors, and cord blood CB. This retrospective study aimed to evaluate the HSCT outcomes from these donors.

Treatment failure was defined as death from all causes, graft failure, and second malignancy. The median follow-up period was 69 range, months. Neutrophil engraftment was achieved after HSCT in all patients. However, the algorithm for donor selection should be considered according to FFS. Further study with a larger number of patients is needed to determine the preferable AD.

Background: Severe Aplastic Anemia SAA is a rare hematological disease characterized by pancytopenia and a hypo cellular bone marrow in the absence of abnormal infiltrates. Allogeneic hematopoietic stem cell transplantation HSCT is the current available curative treatment, however for patients who lack matched sibling donor MSDs , immunosuppressive therapy IST is widely accepted as an alternative first-line treatment.

Outcome data of children with acquired aplastic anemia AA are lacking from our region. Relevant details about treatment given i. An events were defined as death, treatment failure, or rejection. Results: Thirty children were included in the study. Fifteen Out of twelve children treated with IST, three were evaluable for response. Two children died before receiving a rescue transplant. Seven of the patients failed upfront IST and received rescue transplants, of these two children died with infection and rejection.

Conclusions: We observed an inferior outcome in patients who received immunotherapy in our study comparison to published international literature. This could be explained by higher prevalence of consanguineous marriages in the Saudi population and their genetic background. Alternative transplant modalities should be considered for those who lack matched family donor. Background: Allogeneic haematopoietic stem cell transplantation allo-HSCT is still the standard treatment for acquired severe aplastic anemia SAA in patients younger than 40 years with sibling donors.

Sufficient and durable reconstitution of haematopoietic donor stem cells is important for successful allo-HSCT. Poor graft function PGF after allo-HSCT is characterized by persistent pancytopenia, immunodeficiency and dependence on blood transfusions, despite of a complete donor chimerism. The probability of developing PGF seems to be increased in the absence of a regulatory bone marrow stromal microenvironment, even in cases where bone marrow is used as a source of stem cells.

The median age of the 26 male and 9 female pts was 28 years range, 17 to A myeloablative conditioning regimen was used in 6 pts, while 29 pts were treated with a reduced intensity immunosuppressive conditioning regimen. The boost stem cell dose was 6. Statistical analysis was performed on with SAS 9. The median time to recovery was 34 days range, for neutrophils and 62 days range, for platelets.

No relapse of SAA developed. The leading causes of deaths were severe infectious complications due to prolonged cytopenia after allo-HSCT in this patient subset. Older age, long duration of disease with consequent heavy exposures to transfusion and active infection at the time of HSCT have a negative influence on outcome, favouring graft failure GF and graft versus host disease GVHD.

This study aimed to evaluate outcome of all SAA patient who received hematopoietic stem cell transplantation at a tertiary centre in Malaysia. Demographics, clinical characteristics and treatment outcomes were collected and analyzed using descriptive statistics.

Results: A total of 84 cases were identified for this study with mean age of Malay ethnicity were the highest Forty-five cases Most of the patients Mean engraftment for neutrophil was However, this finding is not observed with platelet engraftment. Twenty-nine cases Four of the transplanted patients required second allogeneic transplant due to secondary graft failure, however only one survived. Conclusions: This study shows that only small percentage of cases were transplanted less than six weeks from diagnosis.

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Shadow of destiny pc iso torrent Conclusions: Our experience with ABO mismatch is encouraging with good tolerability and disease control even in the advanced stage heavily pre-treated patients. Statistical analysis was performed using Graph Prism. Analysis was separated into direct costs costs directly related to patient care e. Our aim was to know the incidence and epidemiology of AA in a well-defined population. Hence, transplantation in CR1 might overcome the unfavorable prognostic value of RUNX1 mutation and can be recommended as consolidation treatment in this entity. Background: Aplastic anemia Ju taun torrent is life threatening disorder in pediatric age group with increasing incidence nowadays, with hematopoietic stem cell transplant being the 1st line therapy; immunosuppressive therapy IST more info the alternative therapy and is the most commonly used modality of treatment especially.

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